Individual
MRS. GLENDA LEE BASISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
124 LYNNWOOD AVE, BELLE VERNON, PA 15012-2202
(724) 930-7401
Mailing address
124 LYNNWOOD AVE, BELLE VERNON, PA 15012-2202
(724) 930-7401
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL004321L
PA
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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